Problem swallowing? The device gives healthcare professionals a live view of your throat – the Duluth News Tribune

MITCHELL, SD – Swallowing is a complex process. Using approximately 30 pairs of muscles working in perfect coordination, a person will swallow about 600 times each day, often without noticing.

However, various studies estimate that one in six American adults – and most adults in their 80s – experience some degree of difficulty swallowing. Whether caused by a natural or diagnosed health condition, difficulty swallowing can affect your ability to eat, sleep and breathe.

To help diagnose and treat these problems, healthcare professionals may turn to an operation called fibro-optical endoscopic assessment of swallowing or TAXI. It offers a new perspective on the throat, giving a look at the potential swallowing problems that can be caused by tumors, swelling or even natural muscle loss.

During the TAXI assessment, a medical professional – often a speech pathologist – will insert a small tube into the patient’s nose, while a small camera at the end of the tube can get a bird’s eye view down the patient’s throat, usually to monitor the epiglottis. – a small lid that covers the trachea when swallowed.

“For many people, [swallowing] is something that is so natural throughout life that you don’t really think it’s something that will be affected by stroke, traumatic brain injury, age or weakness, “said Kennedy Wayland, a speech pathologist at Avera Therapy in Mitchell. South Dakota. “We want to make sure that our airways remain protected.

If the epiglottis does not turn properly during swallowing, the patient may be at risk of aspirating their food or drink, which can lead to a condition called aspiration pneumonia.

Following the arrival of FEES devices in Mitchell earlier this year, Weyland said she had made five patient assessments.

Kennedy Wayland, SLP

“I was lucky, so far everyone was normal, but [if abnormal]”We can find out where food gets stuck or where fluid stays and whether it gets into the airways,” Weiland said. “Sometimes the patient may not aspirate, but food or fluid gets stuck in the throat.

Before the device needed to assess FEES arrives, patients who need an assessment of ingestion will be given a more complex assessment of barium uptake. With this, the patient will eat or drink something covered with barium, and the radiologist will use X-rays to monitor the progress of food or drink in the throat.
The FEES assessment does not completely replace the need for a barium assessment, Weiland said. It depends more on the individual needs of the patient and what he is experiencing.

“Barium gives us more side view, while FEES gives us a better view of their secretions, swelling or irritation, and we can’t really see that on the modified barium swallow. There are reasons to do both, “said Wayland. “It can be dangerous to transfer a patient to radiology [for a barium evaluation]while the FEE is mobile, so we can do it right next to the bed. “

Weiland said some patients who suffer from mobility or cognitive impairments or illnesses may be more likely to receive one treatment over another based on their level of comfort.

“Someone with advanced Alzheimer’s disease will not feel very comfortable with someone who has a tube that will go down his throat,” Weyland said. “When aroused, putting them on a chair is not as complicated as taking an X-ray.”

Although it may be unnatural for patients to put a tube in their nose, Weyland said it doesn’t hurt as much as it does for the COVID-19 test. Weiland said it was so simple that she did tests on herself.
“It’s pretty smooth, it gets a lot better if you just wet the ends of the probe. The main thing that happens a lot is that the patient may start sneezing, but after a certain moment, you will not feel anything but pressure, “said Wayland. “In fact, we managed to do some of the training on ourselves. If I can go through it 15 times, you can go through it once. “

Because the device is relatively small, Wayland said Avera can take it to pop-up clinics across the region, evaluating individuals who may not be able to easily do so in a facility where the device is available.

Barium Swallow.gif

Assessment of barium uptake revealed a leak in a patient’s throat as part of a case presented in a medical journal.

Image courtesy of Acute and Critical Care Journal

“We can do it anywhere. We cover a lot of outreach facilities and sometimes it can be really difficult to get a patient to transport to go to the hospital. That allows us to come to the patient, “Weiland said.

If healthcare professionals find a serious problem with the patient’s swallowing, they can refer the patient for treatment. Some common examples of problems, including natural muscle deterioration, which can be exacerbated by electrical training.

“The main way we do this is called neuromuscular electrical stimulation, in which we attach the electrodes to the muscles to swallow and contract them through stimulation,” Weyland said, adding that some oral motor exercises with electrodes can help strengthen target muscles. .

Ratings are covered by Medicare, as patients who need a FEES assessment are usually older. However, Weiland made it clear that most commercial insurances also cover it with a co-payment, as the assessment is not limited to older patients.

Weiland said that while Mitchell is one of Avera’s first properties to receive the FEES machine, extensions to Avera McKennan in Sioux Falls are planned this year. The technology could be extended to other Avera sites in the coming years.

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